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Endothelin in diabetic renal disease.
Contributions to Nephrology
|September 7, 2011
Summary
Endothelin (ET) receptor blockers show promise in reducing proteinuria in diabetic nephropathy patients. Further research is needed to assess their long-term impact on kidney health and survival.
Area of Science:
- Nephrology
- Endocrinology
- Pharmacology
Background:
- Diabetic nephropathy is a leading cause of end-stage renal disease, with increasing prevalence.
- Current therapies offer only partial renal protection.
- The endothelin (ET) system plays a role in hypertension and kidney disease, including diabetic nephropathy.
Purpose of the Study:
- To explore the role of the endothelin system in diabetic nephropathy pathogenesis.
- To evaluate endothelin receptor blockers as a therapeutic strategy for diabetic nephropathy.
Main Methods:
- Review of experimental data and clinical studies on endothelin receptor blockers in diabetic nephropathy.
- Analysis of findings from studies like ASCEND and atrasentan trials.
Main Results:
- Endothelin receptor blockers have demonstrated nephroprotective effects in animal models of diabetes.
- Clinical data on ET receptor blockers in diabetic nephropathy patients is controversial but suggests antiproteinuric effects.
- Recent trials indicate a specific antiproteinuric effect of atrasentan, even with existing renin-angiotensin system blockade.
Conclusions:
- Endothelin receptor blockers represent a potential therapeutic option for diabetic nephropathy.
- Further investigation is warranted to clarify their role in improving hard endpoints like kidney and patient survival.
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